The timeliness and reliability of the delivery of body care for the frail elderly is crucial to the maintenance of their health. This physical caregiving for those with mobility impairments may include repositioning assistance to prevent or aid healing pressure ulcers, toileting assistance or incontinence product changing, bathing, aid with exercise, and feeding assistance. Institutional routine body care, whether at a geriatric acute care hospital or in a nursing home, is usually delivered by nursing aides. Nursing aides have large workloads, are not often paid well and, hence, have high job turnover rates, and may have written language difficulties if they are recent immigrants. It is not easy for clinical management to monitor the reliability of care delivery by nursing aides since much of the care is done in the privacy of a patient's room and leaves no obvious observable "residue". Little technology is available to monitor physical caregiving. Elderly clients with memory impairments or dementia may not be able to report care deficiencies and there are social reasons why cognitively intact patients don't often report caregivers' oversights. Without a means to monitor the timeliness and reliability of caregiving, clinical management is impaired in its ability to correct care process deficiencies and to reward those who are most conscientious in their work. The focus of this application is to develop a wearable body position monitor that can assist in managing physical caregiving and facilitate care quality assurance programs. In application phase 1, we plan to develop a position and range of motion recording device that is so small that it can fit in the gauze of a standard 3/4" Band-Aid, so inexpensive that it can be routinely used to sustain care improvement programs, and so robust that it can be depended upon to provide years of service. In application phase 2, we plan to develop software that automatically identifies the movement signatures of crucial aspects of body care and reports the timeliness of care delivery without the need for clinician data analysis expertise.